Two key documents — kept from the public until now — provide some insight into how the Alberta government came to ease public health measures against COVID-19 earlier this year.
The Court of Queen’s Bench Justice in Edmonton recently rejected the government’s request for cabinet confidentiality and ordered a PowerPoint presentation and cabinet minutes to be released. It stems from a case challenging a decision to lift the province’s school mask mandate and block school boards from introducing their own.
Lawyers for the Alberta Federation of Labor (AFL) and the parents of five immunocompromised children say Albertans have a right to know what led to the decision to overturn the mandate.
The first of the long-awaited documents is a Feb. 8 PowerPoint presentation prepared by Alberta’s chief medical officer of health, Dr. Deanna Hinshaw, which was presented by Health Minister Jason Copping, according to the province.
ISSUE – Sections 13 & 14 are CMOH Hinshaw PowerPoint & Cabinet Committee Minutes. Now a public record. https://t.co/g5JQHtOkNv
—@Sharonadactyl
It offers three possible options for lifting the restrictions, ostensibly crafted within the parameters of earlier guidance from the Priorities Implementation Cabinet Committee (PICC).
“Under previous PICC guidance, three-step approaches to relief are proposed, with an emphasis on eliminating the waiver program and easing masking requirements for youth,” the PowerPoint presentation said.
The first option offers significant relief in Step 1, including the immediate removal of masking at school.
The second option assumed more moderate easing initially with unmasking at school in Step 2.
The third option left the approach open to the cabinet committee.
“The options presented to cabinet were very skewed in favor of lifting the restrictions,” said Laurian Hardcastle, who teaches health law and policy at the University of Calgary.
This summary of options for easing public health measures was included in a February 8 PowerPoint presentation prepared by Alberta’s Chief Medical Officer, Dr. Deanna Hinshaw. (CBC)
“Interestingly, in what I would have expected to be a scholarly discussion, there were considerations of political and economic issues. And it stands out to me that one of the pros listed in that presentation was for Alberta to be a leader in reopening, and that has nothing to do with science. It’s politics.”
In its discussion of the timeline, the paper notes that certain unspecified benchmarks must be met before moving on to the next steps and that “Alberta will be a leader in entering the endemic space, balancing the risks and benefits of mitigation against other Canadian jurisdictions.”
Cabinet Committee Minutes
The provincial government was also ordered to hand over the minutes of a cabinet committee meeting on February 8, the day it announced plans to lift public health measures.
The minutes, which include the decision made but no discussion documentation, indicate that the second, more moderate option was chosen.
But the framework for easing restrictions that was actually put in place differs from the second option presented to the cabinet, and the plan appears to have been changed.
The province removed the wearing of masks in schools two weeks after moving to Step 1 and before moving to Step 2. It also removed the province’s blanket masking mandate earlier than the scenario outlined.
According to Hardcastle, without a record of the cabinet discussion, it is impossible to know exactly what led to the changes.
“We don’t have a lot of information about how and why this decision was made, and I think that’s unfortunate from a liability perspective,” she said.
Laurian Hardcastle teaches in the Departments of Law and Medicine at the University of Calgary. (Colin Hall/CBC)
While the PowerPoint laid out a plan to lift public health measures, it also noted that Alberta is not yet in an endemic phase.
Any easing of measures, he said, “must be based on declining rates of new hospitalizations with COVID-19 over a sustained period of time.”
The PowerPoint noted that the COVID positivity rate at the time had been stable for several weeks, and while hospitalizations appeared to be “plateauing,” they were “still high and straining the system.”
He also warns that once the COVID infrastructure is “reduced”, it will be difficult to recover quickly and that an increase in cases will be expected as restrictions are eased.
“If the situation worsens and a continued transition to endemic is not possible due to the level of strain on the emergency response system, a resumption of public health measures may be recommended,” the PowerPoint said.
The AFL, which is one of the complainants in the case, called the revelations in the documents “disturbing”.
“Their eyes were clearly focused on politics and their own narrow political interest rather than the wider public interest where their focus should have been,” AFL president Gil McGowan said.
“I find it really disturbing that the Government took a decision which would have affected the health and safety of so many people, including our children, just so they could say they were first. It’s not something that should be on them. What they should be focusing on is the public interest and public safety, not bragging rights.”
The Alberta government is defending the decision
The Alberta government said the documents filed in court show what they have argued all along.
“We have moved forward with a plan to safely lift public health measures, consistent with other provinces and other countries, based on the best available evidence and advice from Alberta Health and the Chief Medical Officer of Health,” Steve Buick, press secretary to the Minister of health Copping said in a statement emailed to CBC News.
“We stand behind our decision to lift public health measures, including ending the mandatory wearing of masks in schools. It was the right choice for the children and did not pose an unnecessary risk to our communities.”
Buick said the documents show the provincial government did not ignore the advice contained in the PowerPoint presentation.
Suggestions we’ve ignored or ignored recommendations are simply false. – Steve Buick, Press Secretary to the Secretary of Health
“The Minister of Health presented Cabinet with three options, presented equally with no recommended option. The cabinet chose from these options. The suggestions that we have ignored or rejected the recommendations are simply wrong,” Buick said, adding that the provincial government is determined to avoid school disruptions in the future as much as possible.
What these documents highlight, according to one expert, is the distinction between public health and political decision makers.
“It would not be unusual for there to be fairly strict general guidelines announced by the decision-maker and then the public service working within those guidelines to give options on the precise details of implementation,” said Dr Michael Currie, is a clinical associate professor in the Department of Emergency Medicine at the University of British Columbia who teaches legal and ethical issues.
“So I think what Albertans can understand is that there was a discussion between cabinet that put some constraints on the options that would be presented by the public health service, and the public health service presented a number of expert recommendations of the cabinet. But the exact implementation seems to have been a cabinet decision.”
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